Winchester D P
Department of Surgery, Evanston Hospital, Evanston, Illinois, USA.
Surg Clin North Am. 1996 Apr;76(2):279-87. doi: 10.1016/s0039-6109(05)70439-4.
Breast cancer is an uncommon disease in women under the age of 40 years, reportedly accounting for 7.5% of reported cases. Delay in diagnosis is attributable to a clinically low index of suspicion, difficulty in examining dense and nodular breasts in younger women, and less frequently performed screening mammography. Genetic mutations should be suspected in women with breast cancer who are under the age of 30 years. In relation to older women, younger women have more adverse pathologic features and have a poorer prognosis. Younger age, per se, is not a contraindication to breast-conserving surgery. In node-negative young women, the benefits of adjuvant chemotherapy need to be considered in relation to the short- and long-term risks of treatment. A strong support system should be in place to deal with the adverse psychosocial impact of the disease.
乳腺癌在40岁以下女性中并不常见，据报道占报告病例的7.5%。诊断延迟归因于临床怀疑指数低、年轻女性致密结节性乳房检查困难以及乳腺钼靶筛查开展频率较低。30岁以下的乳腺癌女性应怀疑存在基因突变。与老年女性相比，年轻女性具有更多不良病理特征且预后较差。年轻本身并非保乳手术的禁忌证。对于淋巴结阴性的年轻女性，需要综合考虑辅助化疗的短期和长期治疗风险及其益处。应建立强大的支持系统以应对该疾病带来的不良社会心理影响。
